Eligible Student Transfer Certificate
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Eligible Student Transfer Certificate
NOTE: This form must be completed and a copy maintained at the school for inspection at the request of the OSAA
prior to participation by the student listed below in any interscholastic contest.
Name of School
City
Name of Student
Birth Date
/
/
Month / Day / Year
Name of parents and address of joint residence
Student’s Place of Birth
Student’s Age
ACADEMIC HISTORY
Date of first enrollment in high school or registration in home school
If home school student, date and score of last test
School from which transferring
Dates Attended
Last date that student attended classes, games or practices at school from which transferring
If transferring between school districts under teams of a Reciprocal Transfer Agreement, mark here:
Attach documentation to support the fact that the transfer has been approved by both the
sending and receiving school districts.
Date(s) of enrollment and name(s) of any other high school(s) attended:
Freshman Year
Sophomore Year
Junior Year
Senior Year
Does the student satisfy the OSAA academic eligibility requirements (Rule 8.1) by:
Being enrolled full time during the last grading period?
YES
NO
(Circle One)
Attending regularly during the last grading period?
YES
NO
(Circle One)
CERTIFICATION BY SUPERINTENDENT OR PRINCIPAL
I certify that I have investigated the data herein contained and, to the best of my knowledge and belief, this student is eligible
under OSAA rules.
Signature
Superintendent or Principal
Date
CERTIFICATION BY PARENT
Under penalty of perjury, I affirm that no coach, parent, administrator, teacher or other representative of the current school
initiated contact or offered any inducements for the purpose of having the student attend the current school for athletic
participation.
Signature
Parent
Date
Forms – Eligible Student Transfer Certificate Revised 08/15
2016‐2017 Handbook
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